Vagal dysfunction following endoscopic variceal sclerotherapy.
BACKGROUND
Sclerotherapy is associated with complications which involve adjacent structures like the pleura. The effect of sclerotherapy on function of the vagus nerve, which lies in close proximity to the thoracic esophagus, is not clear.


OBJECTIVE
To study gastric acid secretion as a marker of vagal function in portal hypertensive patients who have undergone sclerotherapy.


METHODS
Portal hypertensive patients who had undergone at least three sessions of sclerotherapy were evaluated by mapping gastric acid-secreting mucosa by the Congo red test and by estimating gastric acid secretion using the modified sham feeding test. Patients with portal hypertension who had never been subjected to endoscopic sclerotherapy were recruited as controls.


RESULTS
On Congo red test, complete or substantial reduction in acid-secreting mucosa was observed in eight patients in comparison to none of the controls. Significantly lower acid secretion on modified sham feeding test was observed in these eight patients.


CONCLUSIONS
A lower gastric acid secretion, probably secondary to vagal dysfunction, is seen in patients who have undergone multiple sessions of sclerotherapy; vagus nerve involvement may be secondary to periesophageal inflammation.
Mistry
F P
FP
Department of Gastroenterology, K E M Hospital, Mumbai.
Sreenivasa
D
D
Narawane
N M
NM
Abraham
P
P
Bhatia
S J
SJ
D000328:Adult; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D005744:Gastric Acid / Q000378:metabolism*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000209:etiology; D015911:Sclerotherapy / Q000009:adverse effects*; D014630:Vagus Nerve / Q000503:physiopathology*